Pictures of large medical bills are sometimes shared on social media to show how patients can be blindsided by unexpected costs for care, but as the new year begins, consumers will be offered federal protections to avoid health-care sticker shock.

On Saturday, the No Surprises Act takes effect. Supporters said it will block out-of-network providers from sending large bills to patients who did not choose who cared for them in an emergency situation.

Patricia Kelmar, health care campaigns director for the Public Interest Research Group (PIRG), said getting statements in the mail can be very hard for the many Americans who don't have much in the savings accounts to cover the expenses.

"And when you think about the average out-of-network bill for anesthesia is $1,200, these costs can create a real burden on consumers and can lead to medical debt," Kelmar explained.

She noted under the law, your bill cannot be sent to collections while you have a complaint under review. Groups such as the American Medical Association have sued the federal government, saying while they back the law, they oppose the arbitration process drawn by regulators. And the North Dakota Health Information Management Association worries it could force smaller providers out of business.

The statewide group said consumer protections are needed, but argued the process caters to larger providers who have more patient volume.

Kelmar contends the law is trying to establish reasonable fees based on average contracted rates in a community.

"We're seeing higher-than-average, higher-than-market prices from many specialties that use surprise billing as a way to increase their profits," Kelmar contended.

She added more emergency rooms are being staffed by private-equity firms using contracted specialists.

Groups such as PIRG pointed out while the law will make a difference, they have suggested changes of their own. Kelmar noted the measure addresses air-ambulance service from-out-of-pocket providers, but leaves out ground transport.

"Your ground transportation, the ambulance that we think of when we call 911, those bills from an out-of-network ambulance could still be your financial responsibility," Kelmar cautioned.

According to federal estimates, the law will impact roughly 10 million surprise medical bills each year. Nearly 30 states have similar protections in place, but policy experts say they're often limited in scope. North Dakota is among the states without these protections.

In 1968, Congress passed a law requiring the Food and Drug Administration to minimize people's exposure to wireless radiation, but the agency dropped the ball, according to a new petition filed by a coalition of consumer advocates.

The group wants the FDA to evaluate the public's exposure to radio-frequency radiation emitted by things such as cellphones, laptops, tablets, routers, game consoles and smart meters.

Doug Wood, founder and national director of Americans for Responsible Technology, spearheaded the petition.

"All those things that depend on and emit RF radiation fall under the purview of FDA," Wood explained. "It's the only agency right now, that has both the authority and the responsibility to protect the public health by trying to minimize those exposures as much as possible."

Wood wants the FDA to measure and analyze the public's exposure, especially kids in modern classrooms packed with wireless technology. Then the agency could develop and publicize best practices for minimizing exposure.

The FDA has said it relies on the industry RF radiation exposure standard developed in the 1980s and adopted in 1996 by the Federal Communications Commission. The FDA considers safe any device coming in under the limit.

Wood argued the standard is outdated, considering multiple studies -- including a huge one in 2018 from the National Toxicology Program -- found RF radiation from cellphones led to cancer in rats.

"So they're kind of caught between a rock and a hard place," Wood contended. "On the one hand, they've got a trillion-dollar worldwide industry, depending on them to not say this stuff is dangerous. And they've got a law from Congress saying you are required to protect public health by minimizing that exposure as much as possible."

Ellie Marks, director of the nonprofit California Brain Tumor Association, said her husband Alan is fighting brain cancer which developed right where he held his cellphone for many years.

"Had the FDA done their jobs and properly advised consumers, my husband and family would not have suffered as we have," Marks asserted. "And I know many others quite young who are now deceased from cancers related to their cellphone use."

The FDA has 180 days to evaluate the petition. If it is rejected, advocates would have the option to file suit.

The Montana Legal Services Association has started a program to help young attorneys get started on a path to success - becoming community leaders, run socially conscious law firms, and maintain sustainable businesses.

The Rural Incubator Program for Lawyers creates a way for new attorneys to start their careers by helping connect them to rural clients with pro-bono and reduced-rate services.

Gillian Ellison, the incubator program coordinator, said it helps underserved people in Montana - while also giving lawyers a leg up on networking and kick-starting, or incubating, their careers.

"It's looking at the problem from both ways," said Ellison, "trying to get more attorneys in the rural places and also trying to facilitate the growth of new businesses that serve low-to moderate-income Montanans."

Montana Tribal members also stand to benefit from the rural lawyer incubator program, which requires the attorneys to perform 25 pro bono hours and 225 reduced rate service hours in exchange for training and assistance with business and client development.

Ellison said while the incubator program is especially helpful to underserved Montanans and members of the state's Indigenous tribes, it is also especially useful to lawyers who are just starting out and need the help that comes from more experienced attorneys - which can be difficult to get.

"Especially in a place like Montana where things are so spread out to have networking capacity because the networking and the mentoring is invaluable to a new attorney," said Ellison, "especially if you're not going to be working in a - or getting hired on to work in - a firm. "

The program also makes some tuition reimbursement assistance available for some lawyers who participate.




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Aiming to close the financial literacy divide among teens and young adults, one investment company has set a goal of reaching one million of them by 2025.

The National Center for Education Statistics reported among 15-year-olds, only one in four regularly discusses economics or financial matters with their parents.

The Edward Jones Financial Fitness program is one way to get the information to them.

Nolan Jeter, financial adviser for Edward Jones in Atlanta, said increasing a young person's financial knowledge is also a way to build and enhance their confidence and well-being.

"The biggest difference between people reaching their full potential and financial success is discipline," Jeter contended. "The sad truth is, most people don't know what those disciplines are."

Jeter pointed out the program tackles topics like saving strategies, how to start and use a 401(k) account, and planning for a secure future. To date, he said the program has helped more than 485,000 students, and is on track to double in two years.

A survey by the website WalletHub ranks Georgia 39th among states for overall financial literacy.

Jeter noted it is a common misconception money management skills are not needed if you do not have much to manage. He emphasized students can learn to handle whatever amount they have more effectively.

"This is one of the ways that we're really focused and delivering that impact to these communities," Jeter stressed. "We know that that's where we see the biggest gap between people and working with financial professionals. We know that there are underserved communities, particularly -- especially in the minority communities -- that just simply don't know."

State initiatives also have been set in motion to help increase financial literacy in teens. Last year, Gov. Brian Kemp approved a bill making financial literacy courses compulsory for high school students starting in the next academic year. All students in grades 11 and 12 must complete a half-credit course to be eligible for graduation.


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